Marjolein Oerlemans1, Patrick Dielissen2, Angelique Timmerman1, Paul Ram1, Bas Maiburg1, Jean Muris1, Cees van der Vleuten3,4,5,6,7. 1. a Department of Family Medicine , Maastricht University , Maastricht , the Netherlands. 2. b Department of Primary and Community Care , Radboud University Medical Centre , Nijmegen , the Netherlands. 3. c School of Health Professions Education , Maastricht University , the Netherlands. 4. d School of Medicine, Flinders University , Adelaide , Australia. 5. e University of the Witwatersrand , Johannesburg , South Africa. 6. f Curtin University , Perth , Australia. 7. g Northumbria University , Newcastle upon Tyne , UK.
Abstract
BACKGROUND: A variety of tools have been developed to assess performance which typically use a single clinical encounter as a source for making competency inferences. This strategy may miss consistent behaviors. We therefore explored experienced clinical supervisors' perceptions of behavioral patterns that potentially exist in postgraduate general practice trainees expressed as narrative profiles to aid the grading of clinical performance. METHODS: We conducted semistructured interviews with clinical supervisors who had frequently observed clinical performance in trainees. Supervisors were asked to describe which behavioral patterns they had discerned in excellent and underperforming trainees, during different stages of training, in their careers as clinical supervisor. We analyzed the interviews using a grounded theory approach. RESULTS: The analysis resulted in a conceptual framework that distinguishes between desirable and undesirable narrative profiles. The framework consists of two dimensions: doctor-patient interaction and medical expertise. Personal values appear to be a moderating factor. CONCLUSIONS: According to experienced clinical supervisors, consistent behaviors do exist in GP trainees when observing clinical performance over time. The conceptual framework has to be validated by further observational studies to assess its potential for making robust and fair assessments of clinical performance and monitor the development of consultation performance over time.
BACKGROUND: A variety of tools have been developed to assess performance which typically use a single clinical encounter as a source for making competency inferences. This strategy may miss consistent behaviors. We therefore explored experienced clinical supervisors' perceptions of behavioral patterns that potentially exist in postgraduate general practice trainees expressed as narrative profiles to aid the grading of clinical performance. METHODS: We conducted semistructured interviews with clinical supervisors who had frequently observed clinical performance in trainees. Supervisors were asked to describe which behavioral patterns they had discerned in excellent and underperforming trainees, during different stages of training, in their careers as clinical supervisor. We analyzed the interviews using a grounded theory approach. RESULTS: The analysis resulted in a conceptual framework that distinguishes between desirable and undesirable narrative profiles. The framework consists of two dimensions: doctor-patient interaction and medical expertise. Personal values appear to be a moderating factor. CONCLUSIONS: According to experienced clinical supervisors, consistent behaviors do exist in GP trainees when observing clinical performance over time. The conceptual framework has to be validated by further observational studies to assess its potential for making robust and fair assessments of clinical performance and monitor the development of consultation performance over time.
Authors: Valerie Schmelter; Esther März; Christian Adolf; Teresa L Wölfel; Christian Lottspeich; Martin R Fischer; Ralf Schmidmaier Journal: GMS J Med Educ Date: 2018-05-15